Health Inequities in Palm Beach County

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Introduction

Health inequity refers to the differences avoidable in health among people of different groups. These differences are primarily a result of systems that are unfair, negatively affecting the living conditions of people (Chacon Cid, 2020). The paper below discusses the root causes of health inequities in Palm Beach County, State of Florida, by comparing the health trends of two neighboring counties, namely, St. Johns County and Union County. Furthermore, the paper expounds on the social health determinants that contribute to inequalities.

Health Trends Table in Palm Beach, St. John’s, and Union Counties of Florida

Health Trend Metric	State Average	Palm Beach	St. John’s	Union
Health Outcomes	NA	Categorized above 25% among the healthy counties in Florida (75%-100%)	Graded in the top 25% healthy counties in Florida (Highest 75%-100%)	Classified among lower 25% range in the least healthy county in Florida (lowest 0%-25%)
Health Factors	NA	Graded in top 25% healthiest counties in Florida.	Ranked amongst the healthiest counties in the state of Florida (Highest 75%-100%)	Categorized among the lower middle range counties in Florida (Lower 25%-50%)

Health Outcomes: Length of Life

Health Trend Metric	State Average	Palm Beach	St. John’s	Union County
Premature death (per 100,000 population)	7,200	6,600 (the leading cause of death not listed).	5,300 (the leading cause of death not listed)	17,400 (leading causes of death; heart diseases, malignant neoplasms, intentional self-harm, accidents, and breakdown ethnicity/race: not listed)

Health Outcomes: Quality of Life

Health Trend Metric	State Average	Palm Beach	St. John’s	Union County
Fair/poor health	20%	19%	14%	28%
Poor health physical days	4.0	4.2	3.5	5.6
Low weight of birth	9%	8% (Asian 10%, Black 12%, Hispanic 7%, and White 7%)	7% (Asian 8%, Black 14%, Hispanic 6%, and White 6%)	10% (Black 13%, and White 10%)

Health Factors: Health Behaviors

Health Trend Metric	State Average	Palm Beach	St. John’s	Union County
Adult Smoking	15%	17%	16%	29%
Adult Obesity	27%	22%	23%	37%
Teen Births	20	16 (Asian 3, Black 23, Hispanic 28, White 5)	9 (Black 27, Hispanic 5, White 8)	42 (Black 32, White 45)

Health Factors: Clinical Care

Health Trend Metric	State Average	Palm Beach	St. John’s	Union County
Uninsured	16%	18%	11%	14%
Mental health providers	590:1	460:1	840:1	1090:1
Preventable hospital stays	4,684	3900	3578	5918

Health Factors: Social and Economic Factors

Health Trend Metric	State Average	Palm Beach	St. John’s	Union County
High school completion	88%	88%	95%	77%
Children in Poverty	18%	16%(Asian 15%, Alaska Native and American Indian Native 2%, Black 28%, Hispanic 24%, White 7%)	7% (American Indian &Alaska Native 26%, Asian 2%, Black 20%, Hispanic 6%, White 6%)	20% (Black 43%, Hispanic 34%, White 26%)
Violent crime (Per 100,000 population)	484	452	225	273

Health Factors: Physical Environment

Health Trend Metric	State Average	Palm Beach	St. John’s	Union County
Air Pollution: particulate matter (micrograms per cubic meter)	7.7	6.2	8.2	7.7
Severe housing problems	20%	22%	13%	16%

Comparative Analysis of the Three Counties

Concerning the health outcomes and health factors, both Palm Beach county and St. John’s county are ranked among the top 25% healthiest counties in Florida as compared to Union county, which had the lowest ranking below 25% for health outcomes with a lower-middle range for the health factors (“County Health Rankings & Roadmaps,” 2021).
In comparing the three counties, Union county had the highest recording of 17400 in 2021 for the premature deaths per 100,000 populations, followed by Palm Beach (6,600 death) and lastly, St. John’s county with 5300 deaths. In 2021, Palm Beach had a poor/fair health record of 19% in terms of quality of life, with St. John’s having a slightly lower record of 14%.
Only Union county recorded the highest at 28% (poor/fair health) in life quality. Poor physical health days had a record of 4.2 for Palm Beach, 3.5 for St. John’s, and 5.6 for Union county. 8% of the population was recorded for the number of women giving birth to low birth weight children in Palm Beach, 7% slightly lower in St. John’s, and 10% high record in Union County.
17% of the adult population in Palm Beach County are smokers compared to Union County, with a 29% record and a slightly lower record of 16% in St. John’s. Palm Beach County had the lowest record of adult obesity at 22%, followed by St. John’s (23%) and Union County (37%).
Teen births were lowest for St. John’s at 9, Palm Beach at 16, and Union at 42. The majority of the teen births came from blacks across the three counties.
18% of the people living in Palm Beach had no clinical care insurance cover, which is the highest record compared to Union (14%), and St. John’s (11%).
The mental health providers to patient ratio were the lowest for Palm Beach County (460:1), with a preventable hospital stay of 3900 people. Only St. Johns had the lowest number of children languishing in poverty (7%) compared to Palm Beach (16%), most of them being American Indian and Alaska.
Notwithstanding, the rate of air pollution in Palm Beach was lower at 6.2 micrograms per cubic meter than St. John’s (8.2), recording the highest value, and Union with a record of 7.7. Furthermore, Palm Beach faces challenges of severe housing problems with a record of 22% compared to St. John’s (13%) and Union (16%).

Social Determinants of Health

Social health determinants are channels in which the effects play out (Palmer et al., 2019). Well-known factors associated with Palm Beach county’s health status and outcomes include smoking, physical activity, and nutritional habits. From the analysis of Palm Beach County, the paper identifies the following social determinants of health (health inequity); education, housing, physical environment, social environment, and health system and services.
Education: can be conceptualized as being both an outcome and a process. There is a positive correlation between the attainment of education and health status indicators such as obesity, life expectancy, and health behaviors such as smoking and screening behavior (Baciu et al., 2017). From the study of the county, it can draw clearly that poor education level has harmed the people as evidenced by 17% adult smoking, 22% adult obesity, and high teen birth of 16% in comparison with St. John’s County.
Income inequality and concentration of poverty: inequality in income is increasing in the United States, making many people unable to cater for their medical bills (Iceland & Hernandez, 2017). Poverty concentration in a county is a critical factor that shapes the way people live. The disproportionate concentration of poverty affects the ethnic and racial minorities across all social health determinants. Poverty concentration brings about a disparity in health and educational outcomes. It is closely related to Palm Beach County, which recorded the highest percentage of children in poverty at 16% compared to St. John’s with 7%. This can be attributed to the highest number of violent crimes (452), and teen births (16), and low birth weight (8%) due to lack of nutrition as compared to the health status of St. John’s County.
The specific populations affected by the inequalities are majorly children and young teenagers. This is supported by the high teen births (16) and 16% increase of children living in poverty in Palm Beach County compared to 7% of children in St. John’s County. Concerning race, black children and teenagers are majorly affected by poverty (28%), followed by Hispanics (24%).

Conclusion

Social health determinants are the root cause of the inequality that has been shaped by the norms and policies of Palm Beach County. The inequities in health are the result of random occurrences or more than the choices of an individual. They are the result of the ongoing interplay and history of inequitable policies and structures that shape life. Social determinants are also determined by norms, structures, and policies put in place by the county government.

References

Baciu, A., Negussie, Y., Geller, A., Weinstein, J. N., & National Academies of Sciences, Engineering, and Medicine. (2017). The root causes of health inequity. In Communities in action: Pathways to health equity. National Academies Press (US).

County health rankings & roadmaps. (2021). County Health Rankings & Roadmaps. Web.

Chacon Cid, A. (2020). Understanding health inequalities in the 21st century: the case of UHC in Peru.

Iceland, J., & Hernandez, E. (2017). Understanding trends in concentrated poverty: 1980–2014. Social Science Research, 62, 75–95.

Palmer, R. C., Ismond, D., Rodriquez, E. J., & Kaufman, J. S. (2019). Social determinants of health: future directions for health disparities research. American Journal of Public Health, 109(S1), S70–S71.

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